External Validation of the Prestroke Independence, Sex, Age, National Institutes of Health Stroke Scale (ISAN) Score for Predicting Stroke-Associated Pneumonia in the Athens Stroke Registry.

BACKGROUND AND PURPOSE: The Prestroke Independence, Sex, Age, National Institutes of Health Stroke Scale (ISAN) score was developed recently for predicting stroke-associated pneumonia (SAP), one of the most common complications after stroke. The aim of the present study was to externally validate the ISAN score. METHODS: Data included in the Athens Stroke Registry between June 1992 and December 2011 were used for this analysis. Inclusion criteria were the availability of all ISAN score variables (prestroke independence, sex, age, National Institutes of Health Stroke Scale score). Receiver operating characteristic curves and linear regression analyses were used to determine the discriminatory power of the score and to assess the correlation between actual and predicted pneumonia in the study population. Separate analyses were performed for patients with acute ischemic stroke (AIS) and intracerebral hemorrhage (ICH). RESULTS: The analysis included 3204 patients (AIS: 2732, ICH: 472). The ISAN score demonstrated excellent discrimination in patients with AIS (area under the curve [AUC]: .83 [95% confidence interval {CI}: .81-.85]). In the ICH group, the score was less effective (AUC: .69 [95% CI: .63-.74]). Higher-risk groups of ISAN score were associated with an increased relative risk of SAP; risk increase was more prominent in the AIS population. Predicted pneumonia correlated very well with actual pneumonia (AIS group: R(2) = .885; β-coefficient = .941, P < .001; ICH group: R(2) = .880, β-coefficient = .938, P < .001). CONCLUSIONS: In our external validation in the Athens Stroke Registry cohort, the ISAN score predicted SAP very accurately in AIS patients and demonstrated good discriminatory power in the ICH group. Further validation and assessment of clinical usefulness would strengthen the score's utility further.

POPULATION STRUCTURE AND PRODUCTION OF COPAIBA OLEORESIN BETWEEN VALLEYS AND HILLSIDES OF THE MINING AREA OFTROMBETAS RIVER - PARÁ1

ABSTRACT We aimed in this work to study natural populations of copaiba (Copaifera multijuga Hayne) on the Monte Branco mountain at Porto Trombetas-PA, in order to support sustainable management and the exploitation of oleoresin from copaiba. We studied the population structure of copaiba on hillsides and valleys of the south face of Monte Branco, within Saracá Taquera National Forest, where bauxite ore was extracted in the biennium 2013-2014 by Mineração Rio do Norte (MRN). We produced a 100% forest inventory of the specie and of oleoresin extraction in order to quantify the potential production of the remaining area. The density of copaiba individuals with DBH > 30 cm was 0.33 individuals per hectare in the hillside and 0.25 individuals per hectare in the valley. Both environments presented a density of 0.28 individuals per hectare. The average copaiba oleoresin yield was 0.661±0.334 liters in the hillside and 0.765±0.280 liters in the valley. The average value of both environments together (hillside and valley) was 0.714±0.218 liters. From all individuals with DBH over 30 cm, 38 (58%) produced some amount of oleoresin, averaging 1.113±0.562 liters in the hillside, 1.329±0.448 liters in the valley and 1.190±0.355 liters in both environments together. The results show the need for planning the use of the surroundings of the study area in order to reach the required volume of copaiba to make feasible the sustainable management of oleoresin extraction in the region.

Uutta tietoa Kainuun soista : Kainuun suoselvitys -projektin tulosraportti

Raportissa esitellään Kainuun suoselvitys -projektin keskeisimpiä tuloksia ja niistä vedettyjä johtopäätöksiä. Vuosina 2010–2012 toteutetun projektin tarkoituksena on ollut parantaa tietopohjaa Kainuun soista, ja sitä kautta luoda edellytyksiä soiden eri käyttömuotojen yhteensovittamiselle ja samalla nostaa esille Kainuun soihin liittyviä mahdollisuuksia. Soiden käyttö nähtiin projektissa laajasti, sisältäen paitsi erilaiset taloudellisen hyödyntämisen muodot myös soiden merkityksen ihmisten virkistykselle ja hyvinvoinnille sekä luonnon monimuotoisuudelle ja monille sääteleville toiminnoille. Taustana projektille on samaan aikaan laadittu kansallinen suostrategia. Sen mukaan soiden luonnontilaa muuttavien toimintojen, maa-, metsä- ja turvetalouden, tulisi jatkossa toimia jo ojitetuilla tai muuten merkittävästi muuttuneilla soilla. Näin soiden luonnontilaisuudesta hyötyville soiden käytön muodoille ja ekosysteemipalveluille jää paremmin tilaa toimia. Kainuu on Suomen kolmanneksi soisin maakunta. Suot ovat keskeinen osa sen luontoa ja maisemaa ja myös monipuolinen luonnonvara. Valtaosa Kainuun suopinta-alasta on ojitettu. Uutta tietoa on projektissa tuotettu paikkatietomenetelmin ja kohdennetuin maastoselvityksin. Raportin aihepiirejä ovat Kainuun soiden käyttö, jäljellä olevat ojittamattomat suot, suojeltujen soiden vesitaloudellinen eheys, metsätalouden käytöstä poistuvat ojitetut suot, soiden merkitys virkistyksen ja matkailun kannalta sekä maastossa tutkittujen 143 suon arviointi turpeennoston ja luonnon monimuotoisuuden kannalta. Raportissa esitetään, että kansallisen suostrategian tavoite soiden kestävästä ja vastuullisesta käytöstä ja suojelusta on mahdollista saavuttaa eri toimijoiden yhteistyön ja maankäytön ohjauksen avulla. Se edellyttää sitoutumista suostrategian linjauksiin sekä tietopohjan parantamista soista ja eri toimintojen vaikutuksista. Kainuun suoselvitys -projektissa on osaltaan tuotettu tätä tietoa ja myös kehitelty menetelmiä sen hankkimiseksi.

University jubilees : a new research area in the history of universities

Teema: Yliopistohistoria.

The nature experiences of wilderness recreation leaders : throwing a stone

Through this descriptive exploratory study, the ways that wilderness recreation leaders experience nature are illuminated, deconstructing the assumed environmental benefits of and practices used in outdoor recreation (Haluza-Delay, 2001). This study also offers a foundation for advancing an environmental ethic among wilderness recreation leaders, participants, and organizations. With the continued degradation of and threats to natural environments, and the rising popularity of outdoor recreation participation, the outdoor recreation professional can be a leader in promoting human reconnections to the Earth (Henderson, 1999). Leaders of outdoor recreation experiences play an important role in encouraging these revived relationships to natural settings and can contribute to the necessary environmental consciousness shift needed within Western society (Hanna, 1995; Jordan, 1996). The purpose of this research was to describe the lived-experience in nature of wilderness recreation leaders. Specifically, a phenomenological method of inquiry was used to describe the meaning of nature, the connections and relationships to nature, and the behaviours and emotions experienced in nature by a group of wilderness canoe trip leaders employed by a residential summer camp. In addition to the implications of this research, achieving this outcome provides a rich descriptive understanding of wilderness leaders' experiences—a basis from which to extend future research endeavours and programmatic practices that promote effective environmental outcomes of outdoor recreation participation. Each of the five study participants was employed in the summer of 2003 by an Ontario residential summer camp organization that sponsors extended wilderness river canoe trips for youth. Two in-depth and semi-structured interviews were performed with each participant, asking them to reflect on the canoe trip that they led for the summer camp organization during 2003. Phenomenological data was analyzed according to Colaizzi's (1978) thematic analysis process. Consistent with van Manen's (1997) emphasis on phenomenological writing, the final result presents the essence of the nature experiences of wilderness recreation leaders in the format of a narrative description. This narrative piece is the culmination of this research effort. Throughout the journey, however, various foundations within the outdoor recreation field, such as minimum impact principles, environmentally responsible behaviours, anthropocentric and ecocentric worldviews, and effective leadership are deconstructed and discussed.

The Welland Canals Foundation, Honourable William Hamilton Merritt and the St. Catharines Historical Society and Museum, 1971-1990, n.d.

‘The Father of Canadian Transportation’ is a term commonly associated with William Hamilton Merritt. Although he is most known for being one of the driving forces behind the building of the first Welland Canal, he was many things throughout his life; a soldier, merchant, promoter, entrepreneur and politician to name a few. Born on July 3, 1793 at Bedford, Westchester County, N.Y. to Thomas Merritt and Mary Hamilton, Merritt’s family relocated to Canada shortly after in 1796. The move came after Merritt’s father petitioned John Graves Simcoe for land in Upper Canada after serving under him in the Queen’s Rangers during the American Revolution. The family quickly settled into their life at Twelve Mile Creek in St. Catharines. Merritt’s father became sheriff of Lincoln County in 1803 while Merritt began his education in mathematics and surveying. After some brief travel and further education Merritt returned to Lincoln County, in 1809 to help farm his father’s land and open a general store. While a farmer and merchant, Merritt turned his attention to military endeavours. A short time after being commissioned as a Lieutenant in the Lincoln militia, the War of 1812 broke out. Fulfilling his duty, Merritt fought in the Battle of Queenston Heights in October of 1812, and numerous small battles until the Battle of Lundy’s Lane in July 1814. It was here that Merritt was captured and held in Cheshire, Massachusetts until the war ended. Arriving back in the St. Catharines area upon his release, Merritt returned to being a merchant, as well as becoming a surveyor and mill owner. Some historians hypothesize that the need to draw water to his mill was how the idea of the Welland Canals was born. Beginning with a plan to connect the Welland River with the Twelve mile creek quickly developed into a connection between the Lakes Erie and Ontario. Its main purpose was to improve the St. Lawrence transportation system and provide a convenient way to transport goods without having to go through the Niagara Falls portage. The plan was set in motion in 1818, but most living in Queenston and Niagara were not happy with it as it would drive business away from them. Along with the opposition came financial and political restraints. Despite these factors Merritt pushed on and the Welland Canal Company was chartered by the Upper Canadian Assembly on January 19, 1824. The first sod was turned on November 30, 1824 almost a year after the initial chartering. Many difficulties arose during the building of the canal including financial, physical, and geographic restrictions. Despite the difficulties two schooners passed through the canal on November 30, 1829. Throughout the next four years continual work was done on the canal as it expended and was modified to better accommodate large ships. After his canal was underway Merritt took a more active role in the political arena, where he served in various positions throughout Upper Canada. In 1851, Merritt withdrew from the Executive Council for numerous reasons, one of which being that pubic interest had diverted from the canals to railways. Merritt tried his hand at other public works outside transportation and trade. He looked into building a lunatic asylum, worked on behalf of War of 1812 veterans, aided in building Brock’s monument, established schools, aided refugee slaves from the U.S. and tried to establish a National Archives among many other feats. He was described by some as having “policy too liberal – conceptions too vast – views too comprehensive to be comprehensible by all”, but he still made a great difference in the society in which he lived. After his great contributions, Merritt died aboard a ship in the Cornwall canal on July 5, 1862. Dictionary of Canadian Biography Online http://www.biographi.ca/EN/ShowBio.asp?BioId=38719 retrieved October 2006 Today numerous groups carry on the legacy of Merritt and the canals both in the past and present. One such group is the Welland Canals Foundation. They describe themselves as: “. . . a volunteer organization which strives to promote the importance of the present and past Welland Canals, and to preserve their history and heritage. The Foundation began in 1980 and carries on events like William Hamilton Merritt Day. The group has strongly supported the Welland Canals Parkway initiative and numerous other activities”. The Welland Canals Foundation does not work alone. They have help from other local groups such as the St. Catharines Historical Society. The Society’s main objective is to increase knowledge and appreciation of the historical aspects of St. Catharines and vicinity, such as the Welland Canals. http://www.niagara.com/~dmdorey/hssc/dec2000.html - retrieved Oct. 2006 http://www.niagara.com/~dmdorey/hssc/feb2000.html - retrieved Oct. 2006

Postgraduate Education for Physical Therapists at Cardiopulmonary Area in Colombia

This paper presents the supply of postdegree programs in the cardiopulmonary area in Colombia in orden to show its state and sufficiency. Plans of formation, objectives, curricular approach, methodology and profile of performance are analyzed in terms of costs, duration, supply, location and research capabilities. Our results show problems in regard to supply as well as unanimous criteria and strategic alliances. There are no Gremial associations that favor both discussion and analysis about epidemiologist aspects of respiratory and cardiovascular diseases in Colombia there is necessity of professionals in this area with experience. Knowledge and appropiated skills in management, administration, laws, agreements and public policies that cover the affected population. Also, it is exposed that the Universities whit this programs require support and pursuit for professionals positioning both in national and international context.Methodology A descriptive study was carried out with a data collection made in a period between April-December of 2006. Cards were done and they allowed to review different aspects such as costs, occupational profile, duration, modality, methodology, practical component and evaluation in the offering universities of programs of postdegree in the cardiopulmonary area for physiotherapists. Later an analysis was made on curriculum, profiles, objectives, contents, professional competitions the areas of research.

Small-area variation in health care affecting the choice of cesarean delivery: the case of a Colombian health insurer

In the midst of health care reform, Colombia has succeeded in increasing health insurance coverage and the quality of health care. In spite of this, efficiency continues to be a matter of concern, and small-area variations in health care are one of the plausible causes of such inefficiencies. In order to understand this issue, we use individual data of all births from a Contributory-Regimen insurer in Colombia. We perform two different specifications of a multilevel logistic regression model. Our results reveal that hospitals account for 20% of variation on the probability of performing cesarean sections. Geographic area only explains 1/3 of the variance attributable to the hospital. Furthermore, some variables from both demand and supply sides are found to be also relevant on the probability of undergoing cesarean sections. This paper contributes to previous research by using a hierarchical model and by defining hospitals as cluster. Moreover, we also include clinical and supply induced demand variables.

How well do regional or national Breeding Bird Survey data predict songbird population trends at an intact boreal site?

A study to monitor boreal songbird trends was initiated in 1998 in a relatively undisturbed and remote part of the boreal forest in the Northwest Territories, Canada. Eight years of point count data were collected over the 14 years of the study, 1998-2011. Trends were estimated for 50 bird species using generalized linear mixed-effects models, with random effects to account for temporal (repeat sampling within years) and spatial (stations within stands) autocorrelation and variability associated with multiple observers. We tested whether regional and national Breeding Bird Survey (BBS) trends could, on average, predict trends in our study area. Significant increases in our study area outnumbered decreases by 12 species to 6, an opposite pattern compared to Alberta (6 versus 15, respectively) and Canada (9 versus 20). Twenty-two species with relatively precise trend estimates (precision to detect > 30% decline in 10 years; observed SE ≤ 3.7%/year) showed nonsignificant trends, similar to Alberta (24) and Canada (20). Precision-weighted trends for a sample of 19 species with both reliable trends at our site and small portions of their range covered by BBS in Canada were, on average, more negative for Alberta (1.34% per year lower) and for Canada (1.15% per year lower) relative to Fort Liard, though 95% credible intervals still contained zero. We suggest that part of the differences could be attributable to local resource pulses (insect outbreak). However, we also suggest that the tendency for BBS route coverage to disproportionately sample more southerly, developed areas in the boreal forest could result in BBS trends that are not representative of range-wide trends for species whose range is centred farther north.

Errors associated with the preparation of aseptic products in UK hospital pharmacies: lessons from the national aseptic error reporting scheme

Background Pharmacy aseptic units prepare and supply injectables to minimise risks. The UK National Aseptic Error Reporting Scheme has been collecting data on pharmacy compounding errors, including near-misses, since 2003. Objectives The cumulative reports from January 2004 to December 2007, inclusive, were analysed. Methods The different variables of product types, error types, staff making and detecting errors, stage errors detected, perceived contributory factors, and potential or actual outcomes were presented by cross-tabulation of data. Results A total of 4691 reports were submitted against an estimated 958 532 items made, returning 0.49% as the overall error rate. Most of the errors were detected before reaching patients, with only 24 detected during or after administration. The highest number of reports related to adult cytotoxic preparations (40%) and the most frequently recorded error was a labelling error (34.2%). Errors were mostly detected at first check in assembly area (46.6%). Individual staff error contributed most (78.1%) to overall errors, while errors with paediatric parenteral nutrition appeared to be blamed on low staff levels more than other products were. The majority of errors (68.6%) had no potential patient outcomes attached, while it appeared that paediatric cytotoxic products and paediatric parenteral nutrition were associated with greater levels of perceived patient harm. Conclusions The majority of reports were related to near-misses, and this study highlights scope for examining current arrangements for checking and releasing products, certainly for paediatric cytotoxic and paediatric parenteral nutrition preparations within aseptic units, but in the context of resource and capacity constraints.

The UK Department of National Heritage: a model for the development and integration of leisure policy in the new Europe?

Leisure is in the vanguard of a social and cultural revolution which is replacing the former East/West political bipolarity with a globalised economic system in which the new Europe has a central rôle. Within this revolution, leisure, including recreation, culture and tourism, is constructed as the epitome of successful capitalist development; the very legitimisation of the global transmogrification from a production to a consumption orientation. While acting as a direct encouragement to the political transformation in many eastern European states, it is uncertain how the issue of leisure policy is being handled, given its centrality to the new economic order. This paper therefore examines the experience of western Europe, considering in particular the degree to which the newly-created Department of National Heritage in the UK provides a potential model for leisure development and policy integration in the new Europe. Despite an official rhetoric of support and promotion of leisure activities, reflecting the growing economic significance of tourism and the positive relationship between leisure provision and regional economic development, the paper establishes that in the place of the traditional rôle of the state in promoting leisure interests, the introduction of the Department has signified a shift to the use of leisure to promote the Government's interests, particularly in regenerating citizen rights claims towards the market. While an institution such as the Department of National Heritage may have relevance to emerging states as a element in the maintenance of political hegemony, therefore, it is questionable how far it can be viewed as a promoter or protector of leisure as a signifier of a newly-won political, economic and cultural freedom throughout Europe.

Do national cultural differences affect the nature and characteristics of HRM practices? Evidence from Australian and Hong Kong construction firms on remuneration and job autonomy

Human resource management (HRM) plays a pivotal role in attracting and retaining talents. However, there is growing recognition in international HRM literature that the adoption of the widely accepted US/Harvard-inspired HRM model ignores the influences of cultural contexts on HRM practices in different countries. This notion has not been empirically investigated in the construction industry. Based on survey responses from 604 construction professionals from Australia and Hong Kong, this study examines whether: (i) national cultural differences influence individuals’ preference for types of remuneration and job autonomy, (ii) actual organizational HRM practices reflect such preferences and (iii) gaps between individuals’ preferences and actual organizational HRM practices affect job satisfaction. Results showed significant difference in HRM preferences between Australian and Hong Kong respondents and these are reflected in the distinct types of HRM practices adopted by construction firms in the two countries. Findings further indicated that the gap between individuals’ preferences and actual organizational HRM practices is associated with job satisfaction. The results support existing mainstream research and highlight the deficiency of the acultural treatment of HRM that is still apparent in construction management literature. An uncritical literature in the area not only hinders theory development but also potentially undermines the ability of construction firms to attract, recruit, and retain scarce talents.

History education in comprehensive schools: using school level data to interpret national patterns

This paper reports the findings from two large scale national on-line surveys carried out in 2009 and 2010, which explored the state of history teaching in English secondary schools. Large variation in provision was identified within comprehensive schools in response to national policy decisions and initiatives. Using the data from the surveys and school level data that is publicly available, this study examines situated factors, particularly the nature of the school intake, the numbers of pupils with special educational needs and the socio-economic status of the area surrounding the school, and the impact these have on the provision of history education. The findings show that there is a growing divide between those students that have access to the ‘powerful knowledge’, provided by subjects like history, and those that do not.

Benevolence, hegemony and nationalism: fifty years of the 1949 National Parks and Access to the Countryside Act

This paper reviews the National Parks and Access to the Countryside Act 1949 fifty years since its enactment. The Act is assessed in the light of fifty years of access policy and within the present context of political debates and manoeuvres over the ‘right to roam’. It is concluded that benevolence is still the prevailing attitude towards access provision, maintaining as it does the scope for alternative freedoms and opportunities to exploit land for consumptive practices such as leisure and recreation. As such, it is argued that the notion of the gift (Mauss, 1990) continues to dominate the provision of countryside access in England and Wales.